A family is a big part of people’s lives, especially in tough times, such as when a loved one is battling a substance addiction. Addiction affects more than one person; it affects the entire family. Someone’s drinking or drug use can have adverse effects on everyone that can last a lifetime. Thoughts, actions, and behaviors that accompany addiction can disrupt home life and create an environment of fear, distrust, and danger.
“Families with alcohol and drug problems usually have high levels of stress and confusion.”
There is research that suggests children who grow up in homes where substance use disorders can develop can struggle with emotional and behavioral problems that can change or shape them as adults. They also are at a higher risk of using and/or abusing substances themselves. However, they might also play a significant part in the role of family in preventing drug abuse.
“The negative impacts of parental SUDs on the family include disruption of attachment, rituals, roles, routines, communication, social life, and finances. Families in which there is a parental SUD are characterized by an environment of secrecy, loss, conflict, violence or abuse, emotional chaos, role reversal, and fear,” according to a research titled, “The Impact of Substance Use Disorders on Families and Children: From Theory to Practice.”
High-stress family environments are a risk factor for early and dangerous substance use, as well as mental and physical health problems,” says a passage in a publication published by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Family Members Deal With A Loved One’s Addiction In Their Own Way
The person who is abusing substances often becomes the primary focus of attention, and loved ones adjust to this reality in various ways. In families with alcohol and drug problems, relatives often adopt various roles based on the behavior they exhibit as they try to come to terms with a loved one’s substance abuse issues and interact with the person. Some family members may retreat and avoid the person to protect their own feelings and personal boundaries while others will jump in and try to manage their loved ones as they see fit. Some may even enable their loved ones, whether knowingly or unknowingly, or bargain with them to stop using.
While all of these reactions are understandable, none of them truly helps the person in need of drug or alcohol treatment. The decision to commit to treatment rests with the person who is battling an addiction, but family or close loved ones do share some responsibility in what happens in the family environment when addiction shows up there. The role of the family should not be overlooked by anyone who wants to see their loved one recover from this debilitating brain disease. Below, we look into substance abuse and the family.
Family Roles in Addiction
It is widely believed that in families with alcohol and drug problems, the roles of family members are based on their behavior and how they see themselves. They also can change roles at any time. Sharon Wegscheider-Cruse, a consultant and founding chairperson of the National Association for Children of Alcoholics, says there are six main roles at work in a family that is grappling with a loved one that is abusing alcohol and drugs. These roles can apply to a variety of relationships, including parent-child, child-parent, husband-wife, sibling-sibling, and many more They are:
The Dependent. The Dependent is the person who is having substance abuse and addiction issues and needs recovery to get their life back on track.
This person uses substances to cope with life’s pressures and conflicts and may engage in unhealthy coping behaviors as they try to relate to others. The need to use will continue to spiral out of control, and the Dependent’s behavior will take its toll on surrounding family members who will deal with their loved one in their own way.
This person may or may not reach a point that something must change on their own without the help of family or other loved ones.
The Enabler. The Enabler will do whatever it takes to smooth over their loved one’s addiction.
This person is worried about their loved ones and wants them to get better, but the person struggles with figuring out how to be there for the person. They are in denial of their loved one’s condition and may even make excuses or lie to cover up for the person’s addiction.
Unfortunately, their words and actions only encourage the person to continue on a path that isn’t good for them. The Enabler can be a spouse, partner, or even a child and struggles with allowing their addicted loved to face the full consequences of their substance abuse.
Enabling involves shielding from the consequences that could wake them up to reality. The consequences of addiction are like pain symptoms in the body. No one wants them and it’s tough to see a person you care about go through it. However, pain tells us that something is wrong. Without it, we may do more damage to ourselves without even realizing there is a problem.
Enabling behaviors can take on several different forms. One of the most common is simply helping to put out fires caused by addiction. This can mean helping an addict out with financial issues caused by funding addiction. It can mean lying or covering for them to protect their reputation, job, or emotions. But it can also mean simply allowing them to use your home as a place to use drugs.
Enabling behaviors can also mean not doing anything at all. Ignoring unacceptable behavior, not expressing your emotions and concerns, or not confronting the issue at all can be considered enabling.
Finally, enabling can take the form of self-sacrifice. In many cases, you may be compelled to sacrifice your own needs to help a person who’s addicted. Giving your time, money, health, and emotional well-being to protect a person going through addiction. This sacrifice can often go unacknowledged by the person you are helping. Unfortunately, this form of enabling hurts two people.
True helping, when it comes to addiction, means setting clear rules and encouraging treatment and recovery. Let the person know that drug and alcohol abuse will not be allowed in your home and stick to that rule. Don’t cover for them when addiction has consequences. Continue to encourage them to seek help and be ready to help in any way possible when they decide to pursue treatment.
The Family Hero. The Family Hero, often the eldest child, steps in to care for the family in the place of the person who is addicted. In many cases, this person is a hard-working, high achiever who appears to have it all together. The person takes on stress and feels personally responsible for what is taking place and figuring out how to make things “right” again. This person works to make things as normal as possible to help keep the family on track. This perfectionist approach eventually catches up with the Family Hero, leaving them stressed out, anxious, and possibly disappointed.
The Scapegoat. The Scapegoat is wrongly blamed for the challenges and difficulties in the family to distract from the addict’s behavior. They also could be blamed for situations they had nothing to do with. In some cases, the Scapegoat will begin to believe how they are perceived and come to loathe themselves, and develop low self-esteem. They also may develop trust issues.
The Mascot. The Mascot, usually the youngest child in the family, tries to find humor in a heavy situation and ease stressful, tension-filled situations by making their family members laugh and smile. They try to keep things light to avoid the weight of their loved one’s addiction. Laughter shields the Mascot from their own feelings about their loved one’s addiction.
The Lost Child. The Lost Child may or may not take this role by choice. Either way, the person is the child whose needs were overlooked and neglected while growing up in an environment affected by substance addiction. This person may become withdrawn and do everything possible to remain out of the spotlight. They deal with their loved one’s addiction by staying out of the way and avoiding family conflicts until they are possibly cornered to do so.
Each of the people in these roles is dealing with a family member’s addiction in the way that they know-how. The fact that they all have different approaches to their family member’s addiction means that inevitably, they are not going to get along, which will cause conflict among them. As these disagreements occur over time, they may become frequent and more intense. And, of course, none of the discord is helping the addicted person or the people who are affected by it.
To shed these roles, every family member will have to take an honest look at their role and how it contributes to dealing with substance abuse in the family. Family therapy can help everyone find better and healthier ways to cope and end behaviors that only fuel their loved one’s addiction, not help end it.
Codependent Family Members
Codependency is one of the most common problems within the families of addicted individuals. It’s defined as an unhealthy attachment to a person that results in dysfunction. Codependent family members often fall into the enabler role, though they may not be the only family members that enable addiction. Codependent family members often feel an exaggerated sense of responsibility or protectiveness over the addicted person. However, this protectiveness can get in the way of healthy recovery. For instance, a codependent parent may oppose their addicted child’s willingness to go to treatment if it means being separated from them. Codependent family members are often parents, and especially mothers, but protective siblings may also experience this. Codependent family members often need therapy on their own. Here are some signs of codependency:
- An unhealthy sense of responsibility for another person’s actions
- Putting your health aside to take care of someone else
- Low self-esteem
- Desperate need for approval
- Unhealthy conflict avoidance
- Guilt when doing something for yourself
- Fear of rejection or abandonment
- A habit of making decisions for loved ones
- Need to be around a loved one at all times
- Acting like a martyr for taking care of someone
- Feeling resentful and frustrated in a relationship.
What Are Some Family Issues That Play Role In Addiction?
Family members will not get along all of the time as no family or person is perfect. However, some challenges can contribute to or worsen one’s addiction. If any of these exist in the family environment, a person in active addiction may struggle even further. They are:
- Personality conflicts
- Financial instability
- Unresolved past issues
- Emotional difficulties between family members
- Relationship problems
- Anger, resentment
All of the above can contribute to tensions and stress in the home environment. Tensions and stress can be triggering for a person who is in active addiction, so they seek out substances as they either try to deal with them or avoid them altogether. If you recognize any of these situations in your own family, and you are trying to help a person who can’t stop abusing drugs, alcohol, and/or other addictive substances, you may want to consider family therapy and/or joining support groups that can help you be there for your loved one.
Support groups include:
- Al-Anon Family Groups (www.al-anon.org)
- Alateen (www.alateen.org)
- Alcoholics Anonymous (www.aa.org)
- Adult Children of Alcoholics (www.adultchildren.org)
Source: Substance Abuse and Mental Health Services Administration
Why Family Therapy Matters
There’s nothing easy about addiction.
Confronting it without the proper tools and techniques in place will just frustrate relatives and people with substance abuse issues. And avoiding it will just contribute to further deterioration of the family and their environment. Professional therapy designed for families can help repair dysfunctional relationships that contribute to substance abuse.
This kind of therapy is not just for the person in addiction; it’s also for the people who love and care about them and want to see them live healthier and happier lives. Family members can best help a loved one who’s going through addiction as well as work on themselves, and family therapy can help them do that.
A parent who struggles with addiction risks being a toxic influence in their child’s life. Neglect, depressive or angry behavior, and unintentionally encouraging drug use are all risks associated with using drugs while raising a child.
Raising a child when you struggle with addiction is not easy. With someone relying on you, the additional stress in your life may make it harder, not easier, to quit. This is despite most parents knowing, in some way, their drug abuse is going to hurt their child.
It is estimated that one in four children will be exposed to alcohol abuse or dependence of some kind or another in their family. This does not even take into account households where children may see other types of drug abuse or dependence.
Drug use in the home is called an adverse childhood event (ACE). In simpler terms, it is an experience that hurts a child’s development.
As discussed by the Partnership for Drug-Free Kids and corroborated by numerous other sources, the environment plays a big part in a child’s various risk factors for things like mental illness, diseases, and more. Of every aspect of the environment a child grows up in, home life might be the most impactful.
Types of Family Therapy
Family therapy can take many forms. In general, four main types are used to treat drug addiction.
Cognitive-behavioral family therapy
Cognitive-behavioral therapy (CBT) is a longstanding form of therapy that is often used during the treatment of drug addiction. This method addresses negative thoughts and how exactly those thoughts affect behaviors such as drug use.
The SAGE Encyclopedia of Marriage, Family, and Couples Counseling explains that one family member’s actions can interfere with the workings of the family as a whole; therefore, cognitive-behavioral family therapy helps each member to recognize how their actions influence the whole.
New ways of thinking are explored, and coping strategies are taught during CBT. With cognitive-behavioral family therapy, how these negative thoughts and behaviors affect other members of the family are closely looked at, and tools are learned to improve the behaviors to minimize drug use. During cognitive-behavioral family therapy, the entire family is seen together, and homework plays an integral role.
Solution-focused family therapy
Instead of looking at the problems or issues that may exist within a family dynamic, solution-focused therapy looks closely at what can be done to improve the family unit. This therapy model works to eliminate drug use and dysfunction within the family by putting more weight on what can be done to minimize these actions and fix things going forward.
This type of therapy model is often short-term, and Psychology Today publishes that solution-focused therapy is goal-driven. This means the family will be asked questions to establish goals and then to work out methods and solutions for achieving these goals. In the case of addiction, the goals may commonly center around minimizing drug use.
Systemic family therapy
Systemic family therapy methods hold that each aspect of a person’s life affects the overall family unit. Each area of life needs to be looked at and managed to treat addiction.
A method of systemic family therapy, called brief strategic family therapy (BSFT), is often useful when treating adolescents who struggle with drug addiction, as it addresses each aspect of the child’s life, including the family. Families can work together to improve communication skills, and systemic family therapy promotes positive interactions as a method of deterring drug abuse and negative actions.
The Association for Family Therapy and Systemic Practice reports that systemic family therapy can be accomplished outside the bounds of traditional therapy settings and can be highly effective in treating a variety of issues, including drug abuse. Since systemic family therapy does not always rely on an office setting, the therapist will often go directly to the family.
Structural family therapy
This type of therapy addresses the family dynamic directly. This can be highly effective when roles between parents and children may be reversed or unclear. For example, if a parent is battling addiction, the child will often step up and take on adult roles. Structural family therapy can help to revert these roles to more healthy parameters and establish clear boundaries between each member of the family in their designated and accepted role.
The Family Journal explains that structural family therapy identifies the problems that lie in family hierarchies, rules, roles, and structure to improve the functioning of the overall unit.
Other Things to do to Support Addiction Recovery
Learn About Addiction
Family education, which is different from family therapy, can help families understand what addiction is. There is a great deal of stigma around addiction and addiction treatment, and these negative perceptions and stereotypes do nothing for the person who needs help. They also don’t help families who have someone who needs treatment for a substance abuse problem.
Unfortunately, adverse views keep many people out of treatment because they don’t want to be labeled or ridiculed. There is also a great deal of debate over whether addiction is a true disease or if it’s a lack of willpower or commitment to staying clean. It can be difficult to understand what people in active addiction face if no effort is made to learn what they experience. Taking some time to do so can help loved ones understand and appreciate the struggle that comes with moving on from substance addiction and starting over again.
There is an abundance of information available online, at the library, and in bookstores that can help families understand what addiction is, what it does, and how it is treated.
The National Institute on Drug Abuse (NIDA) offers helpful resourcesthat explain the science of addiction and why it is hard to stop using and abusing substances once a person starts.
Knowing what your loved one is up against as well as your role in helping the person start anew can help everyone stay focused on recovery goals.
Learning about addiction and any stigmas it has is an important first step.
But education alone will not help family members understand what their loved ones face with substance abuse. Nor will that knowledge alone help heal relationships and keep people committed for the long haul that addiction recovery is. For people who want to (and need to) take that next step, addiction family therapy is the best way to go.
Give Your Loved One And Yourself Time
Treatment isn’t a quick fix or “cure” for addiction, so have realistic expectations going into this. In fact, according to NIDA, there is no cure for addiction, and it recommends that people receiving treatment stay in a program for at least 90 days, or three months to improve their chances of having a successful recovery.
Addiction changes the structure and functioning of the brain, and depending on the severity of one’s illness, patience is needed as one relearns everyday tasks and healthy behaviors. There also are lingering consequences of addiction, such as chronic physical health issues, financial difficulties, and broken relationships in need of amending. There’s also the possibility of relapse, so it is important to take recovery one step and one stage at a time.
When is Family Therapy Not Recommended?
Addiction treatment is designed to help an individual achieve and maintain sobriety. Family involvement in addiction treatment can be extremely helpful, but it’s different than when a family seeks therapy together to sort out issues. For doctors and therapists in addiction treatment, their client with a substance use disorder is their first priority. For that reason, there are some situations when family therapy may not be recommended. If the interactions in family therapy would harm the client in any way, it’s not a good therapy option to pursue. It’s often difficult for clients and their therapists to decide if family members should be involved in treatment. For the most part, only family members that are committed to helping the client through the treatment process should be involved. Otherwise, involvement in critical phases in the middle of treatment may do more harm than good. Here are some family members that shouldn’t be involved in treatment:
- Family members in active addiction. Many people that seek treatment still have friends and family members that are in active addiction. Being around loved ones that still use drugs may be a threat to your sobriety.
- Codependent family members. Codependent family members care deeply about the addicted person, but it’s often better for them to seek therapy or treatment on their own before being involved in family therapy with their addicted loved one.
- Abusive family members. If a person in treatment reports being abused by a family member, that person isn’t a good candidate for involvement in family therapy. Even if they are remorseful, it may be better to exclude them from involvement in treatment.
- Family members that can’t attend sessions regularly. Family members that can’t attend sessions regularly may frustrate the client and slow down treatment progress. People that physically can’t attend through physical conditions may cause similar disappointments.
- Family members that are opposed to therapy. Any family member that has opposed treatment may be unhelpful in family therapy.
Get Addiction Treatment Today
At Delphi Behavioral Health Group, we encourage families to address their loved one’s addiction or substance abuse problem together. No matter where your loved one is on their path, it is not too late to get them help, and you can be there for them as they do. Treatment programs at Delphi Behavioral Health Group’s facilities provide unique therapy and counseling methods for certain addictions.